Lower abdominal pain in men

Pain in the lower abdomen in men occurs with prostate diseases (acute and chronic prostatitis, adenoma, cancer), diseases of the urinary organs (cystitis, ICD), venereal infections. Other common causes: IBS, intestinal infections, inflammatory and surgical bowel pathologies. The diagnostic plan for pain in the lower abdomen includes ultrasound, radiography with contrast, endoscopic techniques. Laboratory tests of blood, urine and feces are used. For therapeutic purposes, antibiotics, NSAIDs, alpha-blockers, immunocorrecting and cytostatic drugs are used, surgical interventions are performed.

Causes of lower abdominal pain in men
Prostate diseases
Cystitis
Sexually transmitted infections
Urolithiasis
Tumors of the genitourinary system
Irritable bowel syndrome
Inflammatory bowel diseases
Appendicitis
Inguinal hernia
Intestinal infections
Rare reasons
Diagnostics
Treatment
Help before diagnosis
Conservative therapy
Surgical treatment
Prices for treatment
Causes of lower abdominal pain in men
Prostate diseases
Prostate damage is the most common cause of lower abdominal pain in men. Depending on the type of pathology and the prescription of the process, the pain can be dull and aching, cutting, stabbing. Painful sensations radiate into the scrotum, groin, hip joint area. They are combined with urination disorders, sexual dysfunction. Diseases that are most often manifested by pain syndrome in the lower abdomen include:

Acute prostatitis. At the initial stages of the inflammatory process, moderate intensity pains occur, increasing at night and during urination. The launched process is characterized by sharp pulsating pains in the lower abdomen, in the perineum, which are given to the rectum. To alleviate the symptoms, the patient lies with his legs pulled up to the trunk.
Chronic prostatitis. Men are concerned about the constant dull pain in the pubic area, which becomes more intense at the beginning and at the end of urination. With prolonged abstinence from intimacy, the pain syndrome increases, but in some patients there is an inverse relationship — severe discomfort in the lower abdomen is felt at the moment of ejaculation.
Prostate abscess. With a voluminous purulent process, very severe pains in the lower abdomen are noted, which are pulsating in nature. Often they have a unilateral localization, which corresponds to the affected lobe of the prostate gland. There is an irradiation of painful sensations in the perineum and rectum area.
Prostate adenoma. The development of pain syndrome is characteristic of the subcompensated and decompensated stages, which is associated with urinary retention. Men experience dull bursting pains over the pubis, when feeling this area, the symptoms increase. After urination, the condition is relieved.
Prostate cancer. With a malignant tumor, unlike prostate adenoma, pain appears much earlier. They are constant, dull or aching, increasing with ejaculation and urination. In the later stages, men develop extremely intense painful sensations that are not stopped by standard analgesics.
Cystitis
In acute cystitis, patients experience pain and a feeling of heaviness over the pubic joint. There are painful imperative urges to urinate, and at the end of the act of urination, intense pains in the lower abdomen bother. Patients notice that the urine becomes cloudy, acquires a sharp unpleasant odor. In the chronic form of cystitis, the pain is not intense, usually they occur in men only before urination.

Sexually transmitted infections
STIs include chlamydia, gonorrhea, ureaplasmosis, mycoplasmosis. Such infections in men are acute, accompanied by severe pain in the lower abdomen, giving in the groin and penis. In addition to the pain syndrome, patients complain of burning and itching in the urethra. Gradually, the symptoms subside, aching pains in the supral zone bother a man only in the morning. Another specific symptom of STIs is abundant purulent or mucous urethral discharge.

Urolithiasis
Severe pain in the lower abdomen with irradiation to the inguinal region occurs when stones are localized in the ureter. At the same time, patients behave restlessly, trying to find a position in which the painful sensations will not be so intense. The symptom is combined with nausea and vomiting, reflex delay of defecation and urination, which further aggravates the pain syndrome in men.

Lower abdominal pain in men
Tumors of the genitourinary system
The appearance of pain in the lower abdomen is typical for bladder cancer, urethra, germinogenic and non-germinogenic testicular tumors. Malignant neoplasms cause pain syndrome, which worries men constantly, does not change during urination and sexual intercourse. At the initial stage of the tumor process, the sensations are aching, not intense. The proliferation of neoplasia leads to increased pain, which becomes unbearable.

Irritable bowel syndrome
IBS is manifested by various types and intensity of pain in the lower abdomen in combination with flatulence. Unpleasant symptoms are most pronounced in the morning after waking up. Men complain of cramping painful sensations, usually localized on the left. Against the background of pain syndrome, there are painful urges to defecate, after emptying the intestines, well-being improves.

Inflammatory bowel diseases
Pain in the lower abdomen on the left is characteristic of ulcerative colitis, on the right — for Crohn’s disease. The intensity of the pain syndrome depends on the stage of the process: with exacerbation, men are disturbed by strong dull or paroxysmal painful sensations. In the period of remission, there is a slight discomfort in the abdomen. Symptoms are accompanied by increased stool, the appearance of impurities of mucus and blood in the feces.

Appendicitis
In classic cases of inflammation of the appendix, intense pain is localized in men in the lower abdomen on the right. The soreness increases with pressure in the specified area and a sharp release of the hand. With an atypical location of the appendicular process, pain is felt in the suprapubic zone. Sometimes soreness in the rectum, dysuric disorders are possible. A change in the nature of pain and its spread throughout the abdomen is a prognostically unfavorable sign.

Inguinal hernia
At first, there are periodic dull pains in the lower abdomen, accompanied by the appearance of a tumor-like protrusion in the groin. The soreness is localized on the side of the lesion. Often there is an irradiation of pain in the lumbosacral region, perineum, their intensification during straining and physical exertion. As the hernia increases, the pain syndrome becomes permanent. Acute cramping pains indicate the formation of a pinched inguinal hernia.

Intestinal infections
With dysentery, escherichiosis, campylobacteriosis and some protozoal infections (amoebiasis, balantidiasis), patients feel severe cramps and pain in the lower abdomen, more on the left side. Simultaneously with the pain syndrome, men have painful urges to defecate, which are false. Diarrhea develops up to 10-15 times a day with the release of a small amount of feces with mucus and streaks of blood. After defecation, the intensity of pain decreases.

Rare reasons
Inflammation of the genitourinary organs: paracystitis, vesiculitis.
Blunt abdominal trauma.
Vascular pathologies: varicose veins of the pelvis, Lerish syndrome.
Rare types of hernias: perineal, spigelial line, postoperative.
Chronic pelvic pain syndrome.
Diagnostics
Examination of men with complaints of pain in the lower abdomen is carried out by a urologist or gastroenterologist. The examination begins with a superficial and deep palpation of the abdomen to identify local soreness and muscle tension. Then a finger examination of the prostate is performed through the rectum — the size and consistency of the gland are determined, a painful reaction is detected. To find out the cause of the pain syndrome, a full range of diagnostic methods is selected, which includes:

Ultrasound examination. During ultrasound of the prostate gland, its shape and size are evaluated, local or diffuse changes in the structure are determined. With the help of Dopplerography, blood flow in the prostate is visualized. Ultrasound of the abdominal cavity is necessarily performed — to exclude inflammatory or tumor processes of the gastrointestinal tract.
Endoscopy. In chronic pathologies of the urinary tract, the results of urethroscopy and cystoscopy are indicative. For detailed visualization of the condition of the large intestine, sigmoscopy and colonoscopy are performed. With endoscopic examination, a biopsy can be taken from suspicious areas of the mucosa.
X-ray examinations. If men are suspected of having urological diseases, urethrography and cystography are recommended. With symptoms of intestinal damage, irrigation is prescribed. CT of pelvic organs is informative for the diagnosis of volumetric neoplasms and chronic inflammatory processes.
Histological examination. To verify prostate cancer, a transrectal targeted biopsy is shown, the material of which is studied under a microscope. The analysis of the microstructure of the intestinal wall is important for the differential diagnosis of UC and Crohn’s disease, the detection of intestinal tumors in men.
Laboratory methods. Back-up of a smear from the urethra is required to confirm the diagnosis of STIs. Clinical and bacteriological examination of urine helps to establish cystitis and urethritis. In case of dyspeptic disorder, a coprogram is necessarily carried out. In case of possible prostate cancer, a blood test for PSA is performed.

Consultation of a urologist
Treatment
Help before diagnosis
Considering that the pain in the lower abdomen in men may have different origins, self-medication and the independent use of painkillers is not recommended. To relieve symptoms, the bladder and intestines should be emptied regularly, and prolonged sexual abstinence should not be allowed. Severe pain syndrome, combined with a deterioration in well—being, is an indication for seeking emergency medical care.

Conservative therapy
In order to prevent polypragmasia, treatment of men with pain in the lower abdomen begins only after verification of the diagnosis. Therapy of most mild and moderate forms of diseases is carried out on an outpatient basis, and in severe and complicated course of diseases hospitalization is necessary. The treatment regimen includes several groups of drugs, the main of which are:

Antibiotics. Medications are prescribed for the treatment of acute and chronic prostatitis, STIs, intestinal infections. The selection of the drug is carried out empirically, the drug regimen is adjusted after receiving the results of the antibioticogram.
Alpha-blockers. Medications relieve smooth muscle spasm in men, facilitate the excretion of urine, so the pain syndrome decreases. In prostate adenoma, therapy is supplemented with 5-alpha-reductase inhibitors.
Nonsteroidal anti-inflammatory drugs. NSAIDs have a powerful analgesic effect, therefore they are used both in pathogenetic and symptomatic therapy of lower abdominal pain in men.
Immunomodulators. Medications that stimulate the immune system are necessary for the chronization of inflammatory and infectious processes. They prevent exacerbations, accelerate the treatment process of men.
Cytostatics. The drugs are effective in inflammatory bowel diseases to control symptoms and reduce the frequency of exacerbations. Cytostatics are included in the chemotherapy of oncological diseases of the genitourinary organs in men.
In chronic prostatitis, prostate massage is widely used, which is necessary to eliminate stagnant phenomena in the organ. For urological pain, physiotherapy methods are carried out: laser exposure, ultrasound and electromagnetic therapy, therapeutic microclysms. With IBS associated with psychoemotional disorders, psychotherapy techniques give a good effect.

Surgical treatment
In the presence of prostate adenoma, several options of operations are used: transurethral resection, adenomectomy, laser vaporization of the prostate. In complicated forms of prostatitis, a puncture is performed with drainage of cysts and abscesses. Men with prostate cancer require radical intervention, which includes prostatectomy and lymph node dissection.

For the treatment of urolithiasis, endoscopic operations (contact cystolithotripsy and ureterolithotripsy) and laparoscopic methods (nephrolithotomy, ureterolithotomy) are used. With inguinal hernias, hernioplasty is performed with the installation of mesh allografts. With appendicitis, a gentle laparoscopic or classical laparotomy appendectomy is indicated.

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